As teacher strikes flared this spring in more than half a dozen states, from West Virginia to Arizona, protesters bemoaned stagnant salaries, overcrowded classrooms and a lack of basic supplies such as textbooks and computers.

Often missing from hand-scrawled placards and fiery speeches was an issue that has contributed greatly to the financial woes of America’s schools: skyrocketing health care costs.

Many teachers, like other public employees, have traditionally accepted a trade-off: In exchange for relatively low salaries, they could expect relatively generous benefits, including pensions and low- or no-cost health premiums.

When you go to the hospital for a scheduled procedure, you ought to be able to find out the price in advance. Today, the chances of anything that consumer-friendly happening are slim to none, but times could be changing.

Health and Human Services Secretary Alex Azar recently told a group of hospital executives that the Trump administration was committed to transparency in health care pricing. And a number of states have already enacted laws requiring providers to post prices of the goods and services they are selling.

Price transparency has never been more important. In recent decades, as the cost of American health care has skyrocketed, patients have been paying an increasing share of the burden, often through health plans that have higher out-of-pocket expenses.

DENVER, CO – April 4, 2018. A bill introduced late Wednesday in the Colorado General Assembly would give residents of Colorado the most comprehensive healthcare price transparency in the nation. HB18-1358, introduced by Representative Mike Foote (D – District 12, Boulder), was driven and drafted by BrokenHealthcare.org founder, David Silverstein, in order to create a more functional, trustworthy healthcare market for Colorado residents. The law would require that healthcare providers (doctors, hospitals, clinics and other facilities) publish their prices for all services and would require that health insurance carriers publish (to their members) the prices they have negotiated with all healthcare providers and pharmacies, along with their reimbursement policies. The bill is co-sponsored by Representative Susan Beckman (R – District 38, Arapahoe), Senator Irene Aguilar, MD (D – District 32, Denver) and Senator Kevin Lundberg (R – District 15, Larimer) and has been assigned to Health, Insurance & Environment Committee.

“If you have ever received a medical bill you know that healthcare billing has grown increasingly complex and prices are rising at a rate well ahead of inflation” said Silverstein. “This measure calls for comprehensive healthcare price transparency from all parties. Our healthcare system needs a lot of fixing, but nothing can change until there is full transparency. Americans deserve a healthcare system they can trust. We’d like to see Colorado lead the way to that end.”

In addition to price information from healthcare providers and insurance carriers, the law would require full price information from all pharmacies and would oblige providers, carriers and pharmacies to update their prices as they change. The bill also includes a provision whereby, if a provider has failed to publish its prices at the time a healthcare service is provided to a patient, that patient will not be held responsible for paying the charges associated with that service. Silverstein noted that this legislation is critically different from all previous attempts to legislate healthcare price transparency. “This will work where other laws have failed because we are requiring full price transparency from all commercial stakeholders in the healthcare system. Only when providers, payers and pharmacies are all publishing pricing information, can the healthcare market begin to behave like a fully functional, price-sensitive marketplace. It is also the first step to gaining back consumers’ trust.”

Silverstein and BrokenHealthcare.org are not leaving the fate of Colorado’s healthcare market in the hands of the legislature. Silverstein and fellow sponsor Andrew Graham are backing up the bill with a parallel Ballot Initiative (2017-18 #146 – Comprehensive Healthcare Billing Transparency Act) to put before Colorado voters in November. BrokenHealthcare.org kicked off its signature gathering campaign for the ballot initiative this week. “I challenge the legislators to pass this bill before it is passed by Colorado voters,” said Silverstein. “I’d like Colorado lawmakers to show the nation how this should be done. It’s a non-partisan bill that will benefit every citizen.”

Silverstein expressed his deep appreciation for bill sponsor, Rep. Mike Foote. “Crafting this bill took many months and hundreds of hours of input from doctors, hospital executives, insurance executives, lawmakers and billing experts. Mike supported this from day one and was ready to take the ball and run with it when we finally got it right. I’d like to see the legislature fast-track this critical bill and take it the rest of the way during the next five weeks.”

But after the Lafayette Democrat was approached by a friend who wants to help lower medical costs by making all health care providers and insurance companies more fully disclose what they are charging, Foote couldn’t resist.

As a result, he’s now planning to introduce a never-before-considered proposal into the Colorado Legislature that will closely resemble several proposed ballot measures, each of which attempts to use the free market to force prices down.

“This is unconditional transparency,” Foote said of the idea. “The premise of it is all or nothing. You can’t have partial transparency and have it meaningful. This would create a real market. If you have a real market, the prices won’t be so crazy. You won’t get charged $1,000 for a Kleenex box. In a grocery store market, that would never fly.”

That friend was David Silverstein, founder of BrokenHealthcare.org, a nonprofit group that wants all states to follow Colorado’s lead in forcing complete transparency in health care pricing.

DENVER, CO – December 14, 2017. BrokenHealthcare.org, a not-for-profit organization formed to use innovative strategies to force positive change in the U.S. healthcare system, announced today that a robust measure mandating healthcare price transparency has been submitted to Colorado’s Legislative Council. This is the first step towards putting the measure on the November 2018 ballot, enabling the voters of Colorado to decide this issue for themselves. The measure is designed as a model for state legislation around the country. In Colorado, the ballot initiative’s Proponents are BrokenHealthcare.org Founder, David Silverstein and businessman Andrew Graham. A parallel measure is being drafted by Representative Mike Foote for the Colorado State Legislature to consider. It is the hope of all involved that the legislature succeeds and the ballot initiative becomes unnecessary.

“There is no other marketplace where consumers have so little price information before purchasing a product or service,” said Silverstein. “The U.S. spends more than any other nation on healthcare, and has the worst healthcare outcomes of any economically stable nation. That has to change. Price transparency is a critical first step towards fixing our broken system.”

The bill requires hospitals and other healthcare facilities (“providers”) to publish their “chargemasters,” their full lists of non-discounted charges for supplies and services. They will also be compelled to indicate whether or not their charges can be negotiated. Both facilities and physicians will need to disclose which insurance plans they accept. And, under the law, insurance companies (“payers”) will be required to show their members how hospital payments and patient reimbursement rates are calculated.

“This is not a bi-partisan initiative,” said Silverstein, who is also CEO of Lean Methods Group, a strategic consulting firm. “Healthcare price transparency is a NONPARTISAN issue. We are all healthcare consumers who deserve a strong, functional healthcare system. We look forward to helping Colorado lead the way on this critical national issue.” The complete draft measure can be found here . Silverstein will be holding “open house” office hours for anyone who would like to discuss the measure on December 19th 9a-2p and December 28th 9a-5p. Address is 555 17th Street, Suite 400, Denver, CO.

BrokenHealthcare.org’s Founder, David Silverstein, discussed why healthcare price transparency is the critical first step towards fixing the broken United States healthcare system. During this interview, he announced groundbreaking transparency legislation heading to the Colorado State Ballot and explained how Colorado can lead the nation in this area.

As the father of four sports-playing children, David Silverstein has long grappled with the high cost of hospital care. “There’s always a bill for something,” he said, laughing.

But something changed years ago when he received an emergency room bill for his then-high school-aged daughter, Kailey. The total came to $12,000, but Silverstein’s portion came in just under $1,000.

Despite a background in health care — Silverstein has worked with hospitals and insurance companies for years through his management consulting business — he was flummoxed by the math. The 92% discount may have benefited him, but it also seemed arbitrary and confusing, he said.

But after he paid the bill, he couldn’t get the hospital to respond to his questions. So he decided not to make that mistake again.

He has been challenging hospital bills ever since, and started doing it for non-family in early 2016, through his Colorado-based nonprofit BrokenHealthcare.org. Silverstein estimates that he’s reached a couple of hundred people since, including those who have used his techniques on their own. None of the roughly 40 patients he’s given direct help to have paid a cent, he said.